BILL NUMBER: AB 2400 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MARCH 29, 2012
INTRODUCED BY Assembly Member Butler
FEBRUARY 24, 2012
An act to amend Section 1596.66 of
Sections 1502 and 1507 of, and to add Section 1524.8 to, the
Health and Safety Code, relating to license-exempt child
care providers health and care facilities .
LEGISLATIVE COUNSEL'S DIGEST
AB 2400, as amended, Butler. License-exempt child care
providers. Social rehabilitation facilities.
Existing law, the California Community Care Facilities Act,
requires the State Department of Social Services to license and
regulate community care facilities, including social rehabilitation
facilities, as defined. Existing law authorizes a community care
facility to provide incidental medical services, as specified. A
violation of community care facility provisions is a misdemeanor.
This bill would prohibit a licensed social rehabilitation facility
from employing more than one licensed physician or surgeon or
registered nurse for every 6 patients. This bill would provide that
medical services provided by a social rehabilitation facility that
employs more than one licensed physician or surgeon or registered
nurse for every 6 patients shall not be considered incidental medical
services. This bill would presume excessive a rate charged by a
social rehabilitation facility that is more than 150% of the rate the
state pays for similar services, and require the department to
investigate complaints of excessive rates. This bill would require
the department to issue an order to a facility charging excessive
rates that requires the facility to reduce its rate to an amount that
is no longer excessive, as determined by the department, or justify
its rate at a hearing, as specified, after which the department would
issue an order determining a reasonable rate the facility may
charge.
By expanding the definition of a crime, this bill would impose a
state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Existing law requires a license-exempt child care provider
receiving payment for child care services pursuant to specified
provisions of law to be registered as a trustline provider, unless
the provider is exempted from registration due to being the
grandparent, aunt, or uncle of the child in care.
This bill would make technical, nonsubstantive changes to these
provisions, and would delete an obsolete cross-reference.
Vote: majority. Appropriation: no. Fiscal committee: no
yes . State-mandated local program: no
yes .
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1502 of the Health
and Safety Code is amended to read:
1502. As used in this chapter:
(a) "Community care facility" means any facility, place, or
building that is maintained and operated to provide nonmedical
residential care, day treatment, adult day care, or foster family
agency services for children, adults, or children and adults,
including, but not limited to, the physically handicapped, mentally
impaired, incompetent persons, and abused or neglected children, and
includes the following:
(1) "Residential facility" means any family home, group care
facility, or similar facility determined by the director, for 24-hour
nonmedical care of persons in need of personal services,
supervision, or assistance essential for sustaining the activities of
daily living or for the protection of the individual.
(2) "Adult day program" means any community-based facility or
program that provides care to persons 18 years of age or older in
need of personal services, supervision, or assistance essential for
sustaining the activities of daily living or for the protection of
these individuals on less than a 24-hour basis.
(3) "Therapeutic day services facility" means any facility that
provides nonmedical care, counseling, educational or vocational
support, or social rehabilitation services on less than a 24-hour
basis to persons under 18 years of age who would otherwise be placed
in foster care or who are returning to families from foster care.
Program standards for these facilities shall be developed by the
department, pursuant to Section 1530, in consultation with
therapeutic day services and foster care providers.
(4) "Foster family agency" means any organization engaged in the
recruiting, certifying, and training of, and providing professional
support to, foster parents, or in finding homes or other places for
placement of children for temporary or permanent care who require
that level of care as an alternative to a group home. Private foster
family agencies shall be organized and operated on a nonprofit basis.
(5) "Foster family home" means any residential facility providing
24-hour care for six or fewer foster children that is owned, leased,
or rented and is the residence of the foster parent or parents,
including their family, in whose care the foster children have been
placed. The placement may be by a public or private child placement
agency or by a court order, or by voluntary placement by a parent,
parents, or guardian. It also means a foster family home described in
Section 1505.2.
(6) "Small family home" means any residential facility, in the
licensee's family residence, that provides 24-hour care for six or
fewer foster children who have mental disorders or developmental or
physical disabilities and who require special care and supervision as
a result of their disabilities. A small family home may accept
children with special health care needs, pursuant to subdivision (a)
of Section 17710 of the Welfare and Institutions Code. In addition to
placing children with special health care needs, the department may
approve placement of children without special health care needs, up
to the licensed capacity.
(7) "Social rehabilitation facility" means any residential
facility that provides social rehabilitation services for no longer
than 18 months in a group setting to adults recovering from mental
illness who temporarily need assistance, guidance, or counseling.
Program components shall be subject to program standards pursuant to
Article 1 (commencing with Section 5670) of Chapter 2.5 of Part 2 of
Division 5 of the Welfare and Institutions Code. A licensed
social rehabilitation facility shall not employ more than one
licensed physician or surgeon or registered nurse for every six
residents.
(8) "Community treatment facility" means any residential facility
that provides mental health treatment services to children in a group
setting and that has the capacity to provide secure containment.
Program components shall be subject to program standards developed
and enforced by the State Department of Mental Health pursuant to
Section 4094 of the Welfare and Institutions Code.
Nothing in this section shall be construed to prohibit or
discourage placement of persons who have mental or physical
disabilities into any category of community care facility that meets
the needs of the individual placed, if the placement is consistent
with the licensing regulations of the department.
(9) "Full-service adoption agency" means any licensed entity
engaged in the business of providing adoption services, that does all
of the following:
(A) Assumes care, custody, and control of a child through
relinquishment of the child to the agency or involuntary termination
of parental rights to the child.
(B) Assesses the birth parents, prospective adoptive parents, or
child.
(C) Places children for adoption.
(D) Supervises adoptive placements.
Private full-service adoption agencies shall be organized and
operated on a nonprofit basis. As a condition of licensure to provide
intercountry adoption services, a full-service adoption agency shall
be accredited and in good standing according to Part 96 of Title 22
of the Code of Federal Regulations, or supervised by an accredited
primary provider, or acting as an exempted provider, in compliance
with Subpart F (commencing with Section 96.29) of Part 96 of Title 22
of the Code of Federal Regulations.
(10) "Noncustodial adoption agency" means any licensed entity
engaged in the business of providing adoption services, that does all
of the following:
(A) Assesses the prospective adoptive parents.
(B) Cooperatively matches children freed for adoption, who are
under the care, custody, and control of a licensed adoption agency,
for adoption, with assessed and approved adoptive applicants.
(C) Cooperatively supervises adoptive placements with a
full-service adoptive agency, but does not disrupt a placement or
remove a child from a placement.
Private noncustodial adoption agencies shall be organized and
operated on a nonprofit basis. As a condition of licensure to provide
intercountry adoption services, a noncustodial adoption agency shall
be accredited and in good standing according to Part 96 of Title 22
of the Code of Federal Regulations, or supervised by an accredited
primary provider, or acting as an exempted provider, in compliance
with Subpart F (commencing with Section 96.29) of Part 96 of Title 22
of the Code of Federal Regulations.
(11) "Transitional shelter care facility" means any group care
facility that provides for 24-hour nonmedical care of persons in need
of personal services, supervision, or assistance essential for
sustaining the activities of daily living or for the protection of
the individual. Program components shall be subject to program
standards developed by the State Department of Social Services
pursuant to Section 1502.3.
(12) "Transitional housing placement facility" means a community
care facility licensed by the department pursuant to Section 1559.110
to provide transitional housing opportunities to persons at least 16
years of age, and not more than 18 years of age unless the
requirements of Section 11403 and paragraph (1) of subdivision (a) of
Section 11403.2 of the Welfare and Institutions Code are met, who
are in out-of-home placement under the supervision of the county
department of social services or the county probation department, and
who are participating in an independent living program.
(b) "Department" or "state department" means the State Department
of Social Services.
(c) "Director" means the Director of Social Services.
SEC. 2. Section 1507 of the Health and
Safety Code is amended to read:
1507. (a) Notwithstanding any other provision of law, incidental
medical services may be provided in a community care facility. If the
medical services constitute a substantial component of the services
provided by the community care facility as defined by the director in
regulations, the medical services component shall be approved as set
forth in Chapter 1 (commencing with Section 1200) or Chapter 2
(commencing with Section 1250).
(b) Notwithstanding any other provision of law, if the
requirements of subdivision (c) are met, the department shall permit
incidental medical services to be provided in community care
facilities for adults by facility staff who are not licensed health
care professionals but who are trained by a licensed health care
professional and supervised according to the client's individualized
health care plan prepared pursuant to subdivision (c). Incidental
medical services provided by trained facility staff for the following
conditions shall be limited as follows:
(1) Colostomy and ileostomy: changing bags and cleaning stoma.
(2) Urinary catheter: emptying bags in day care facilities;
emptying and changing bags in residential facilities.
(3) Gastrostomy: feeding, hydration, cleaning stoma, and adding
medication per physician's or nurse practitioner's orders for the
routine medication of patients with chronic, stable conditions.
(c) Facility staff may provide incidental medical services if the
following conditions have been met:
(1) For regional center clients the following shall apply:
(A) An individualized health care plan, which may be part of a
client's individual program plan, shall be prepared for each client
by a health care team that shall include the client or his or her
designee if the client is not able to participate in planning his or
her health care, the client's primary care physician or nurse
practitioner or other health care professional designated by the
physician or nurse practitioner, the licensee or licensee's designee,
any involved social worker or regional center worker, and any health
care professional designated to monitor the client's individualized
health care plan.
(B) The client's individualized health care plan shall be
reassessed at least every 12 months or more frequently as determined
by the client's physician or nurse practitioner during the time the
client receives incidental medical services in the facility.
(C) The client's regional center, primary care physician or nurse
practitioner, or other health care professional designated by the
physician or nurse practitioner shall identify the health care
professional who shall be responsible for training facility staff in
the provision of incidental medical services.
(D) Facility staff shall be trained by the identified health care
professional practicing within his or her scope of practice who shall
monitor, according to the individualized health care plan, the staff'
s ability to provide incidental medical services and who shall
review, correct, or update facility staff training as the health care
professional deems necessary.
(E) The regional center or placing agency shall evaluate, monitor,
and have responsibility for oversight of the incidental medical
services provided in the facility by facility staff. However, nothing
in this section shall preclude the department from taking an
administrative action against a licensee or facility staff member for
failure or refusal to carry out, or negligence in carrying out, his
or her duties in providing these incidental medical services.
(2) For persons who are not regional center clients, the following
shall apply:
(A) An individualized health care plan shall be prepared that
includes the physician's or nurse practitioner's order for services
to be provided during the time the client is in the day care
facility. The plan shall be prepared by a team that includes the
client or his or her designee if the client is not able to
participate in planning his or her care, the client's social worker,
conservator, or legal guardian, as appropriate, a licensed health
care professional, and the licensee or the licensee's designee.
(B) The client's individualized health care plan shall be
reassessed at least every 12 months or more frequently as determined
by the client's physician or nurse practitioner during the time the
client receives incidental medical services in the facility.
(C) A licensed health care professional practicing within his or
her scope of practice shall train the staff of the facility on
procedures for caring for clients who require incidental medical
services and shall periodically review, correct, or update facility
staff training as the health care professional deems necessary.
(d) Facilities providing incidental medical services shall remain
in substantial compliance with all other applicable regulations of
the department.
(e) The department shall adopt emergency regulations for community
care facilities for adults by February 1, 1997, to do all of the
following:
(1) Specify incidental medical services that may be provided.
These incidental medical services shall include, but need not be
limited to, any of the following: gastrostomy, colostomy, ileostomy,
and urinary catheters.
(2) Specify the conditions under which incidental medical services
may be provided.
(3) Specify the medical services that, due to the level of care
required, are prohibited services.
(f) The department shall consult with the State Department of
Developmental Services, the State Department of Mental Health, the
Association of Regional Center Agencies, and provider associations in
the development of the regulations required by subdivision (e).
(g) Medical services that are provided by a social rehabilitation
facility that employs more than one licensed physician or surgeon or
registered nurse for every six residents shall not be considered
incidental medical services.
SEC. 3. Section 1524.8 is added to the
Health and Safety Code , to read:
1524.8. (a) (1) The department shall investigate complaints of
excessive rates charged to residents of a social rehabilitation
facility.
(2) A rate charged by a social rehabilitation facility shall be
presumed excessive if the rate is more than 150 percent of the rate
the state pays for services provided by a social rehabilitation
facility.
(b) The department shall issue an order to a facility the
department determines is charging excessive rates and require the
facility to do either of the following:
(1) Reduce its rate to an amount that is no longer excessive, as
determined by the department.
(2) Justify its rate as reasonable.
(c) If the facility chooses to justify its rate, it shall justify
its rate to the department in a hearing conducted pursuant to the
administrative adjudication procedures in the Administrative
Procedure Act, as described in Chapter 4.5 (commencing with Section
11400) of Part 1 of Division 3 of Title 2 of the Government Code.
(d) On completion of an administrative adjudication pursuant to
subdivision (c), the department shall issue an order establishing a
reasonable rate that the facility may charge its residents.
(e) An order issued pursuant to subdivision (d) may be subject to
judicial review.
SEC. 4. No reimbursement is required by this act
pursuant to Section 6 of Article XIII B of the California
Constitution because the only costs that may be incurred by a local
agency or school district will be incurred because this act creates a
new crime or infraction, eliminates a crime or infraction, or
changes the penalty for a crime or infraction, within the meaning of
Section 17556 of the Government Code, or changes the definition of a
crime within the meaning of Section 6 of Article XIII B of the
California Constitution.
SECTION 1. Section 1596.66 of the Health and
Safety Code is amended to read:
1596.66. (a) Each license-exempt child care provider, as defined
pursuant to Section 1596.60, who is compensated, in whole or in
part, with funds provided pursuant to the Alternative Payment
Program, Article 3 (commencing with Section 8220) of Chapter 2 of
Part 6 of Division 1 of Title 1 of the Education Code or pursuant to
the federal Child Care and Development Block Grant Program, except a
provider who is, by marriage, blood, or court decree, the
grandparent, aunt, or uncle of the child in care, shall be registered
pursuant to Sections 1596.603 and 1596.605 in order to be eligible
to receive this compensation. Registration under this chapter shall
be required for providers who receive funds under Section 9858 and
following of Title 42 of the United States Code only to the extent
permitted by that law and the regulations adopted pursuant thereto.
Registration under this chapter shall be required for providers who
receive funds under the federal Child Care and Development Block
Grant Program only to the extent permitted by that program and the
regulations adopted pursuant thereto.
(b) For the purposes of registration of the providers identified
in subdivision (a), the following procedures shall apply:
(1) Notwithstanding subdivision (a) of Section 1596.603, the
provider shall submit the fingerprints and trustline application to
the local child care resource and referral agency established
pursuant to Article 2 (commencing with Section 8210) of Chapter 2 of
Part 6 of Division 1 of Title 1 of the Education Code. The local
child care resource and referral agency shall transmit the
fingerprints and completed trustline applications to the department
and address any local problems that occur in the registration system.
If a fee is charged by the local child care resource and referral
agency that takes a provider's fingerprints, the provider shall be
reimbursed for this charge by the State Department of Education,
through the local child care resource and referral agency, from
federal Child Care and Development Block Grant funds to the extent
that those funds are available.
(2) The department shall adhere to the requirements of Sections
1596.603, 1596.605, and 1596.607 and shall notify the California
Child Care Resource and Referral Network of any action it takes
pursuant to Sections 1596.605 and 1596.607.
(3) The California Child Care Resource and Referral Network shall
notify the applicable local child care resource and referral
agencies, alternative payment programs, and county welfare
departments of the status of the trustline applicants and registered
trustline child care providers. The network shall maintain a
toll-free telephone line to provide information to the local resource
and referral agencies, the alternative payment programs, and the
child care recipients of the status of providers.
(c) This section shall become operative only if funds
appropriated for the purposes of this article from Item 6110-196-890
of Section 2 of the Budget Act of 1991 are incorporated into and
approved as part of the state plan that is required pursuant to
Section 658E(a) of the federal Child Care Block Grant Act of 1990
(Sec. 5082, P.L. 101-508).